Reducing the Rank of Uninsured Children in Texas

This op-ed ran in the Austin American-Statesman in advance of a Congressional hearing in Dallas about implementation of the Affordable Care Act and the role of navigators, who help people enroll in health insurance. Back in 2009 Lieutenant Governor David Dewhurst made an emphatic endorsement for increasing the number of children enrolled in the Children's Health Insurance Program. "If I had a magic wand, I'd get them all enrolled in the CHIP program," he said. "Why? I think that at the end of the day, it's the moral thing to do, and in the long run, the most economical thing to do."

The moral and economic incentives for maximizing enrollment are there for both moderate-income children who qualify for CHIP and lower-income kids eligible for Children's Medicaid. Both CHIP and Children's Medicaid help children hit important developmental milestones, enter school ready to learn and get check-ups and treatment they need. Health coverage supports families, staving off bankruptcies that can come from unexpected medical expenses. Improved coverage also supports communities, reducing the number of uninsured and all the costs that typically get passed on to others, to be paid for through higher premiums and fees on health services.

We have a unique opportunity right now to make this critical asset more available to Texas children than ever before. For the first time, nearly all Texas children are eligible for coverage--whether through CHIP, Medicaid or the new Health Insurance Marketplace.

Since the roll-out of the Affordable Care Act, more families have found out what's available to them, and more are looking at their options leading up to a Dec. 23 deadline for enrolling in coverage that kicks in at the start of the new year. Most families who are purchasing coverage for their children in the new health insurance marketplace also will receive financial assistance to help pay for health insurance. As more Texans learn about their options and get their kids enrolled, our state's uninsured child rate--the second-highest in the nation--could easily plummet.

That won't take a magic wand, but it will take allowing the health law to work as intended. For example, our state should make sure that enrollment experts through the navigator program can do their jobs without excessive restrictions while still maintaining common sense consumer protections. Applying for health coverage is daunting, and we shouldn't be making it harder for people to get the information they need to learn about their options and sign up.

Similarly, our state leaders should oppose red tape to health coverage for children. The Affordable Care Act eliminated some of the hoops that Texas families must jump through, and our state leaders should stop fighting the removal of these barriers within Medicaid.

We can also hold strong in areas where we have made progress. Foster youth who leave state care, without ever having been adopted, are some of the young adults most vulnerable to poor health and life outcomes. Maintaining their health coverage options as they leave care is a way of safeguarding these youth and putting them on a better trajectory. Our state administration is currently proposing eroding these benefits for some former foster children, leaving young adults who have no family support to fend for themselves.

Finally, Texas can stop standing in the way of whole family coverage. Roughly 1 in 3 adults who aren't seniors are uninsured, and many hard-working, low-income parents have no affordable options for health insurance. As a result, researchers say, many also won't know about the options available to their children. One of the best things our state can do to support families' economic security and their health is accepting a way to get every family member the coverage they need. The state still has the opportunity to connect Texas families to expanded eligibility in the Medicaid program if it chooses to.

Our state's delay in accepting this expansion has left federal funds on the table and created a coverage gap for hundreds of thousands of working parents in Texas. A recent report sponsored by the Commonwealth Fund found just how costly it will be to continue to delay coverage expansion. Through 2022, the cost to Texas taxpayers of this delay will be over $9 billion. That will result in fewer jobs created and fewer resources flowing through our local communities.

Texas is making progress, but more than a million kids in the Lone Star State remain uninsured. Meeting our state's moral obligation and maximizing opportunity for our state's economic future doesn't require a magic wand. It requires the resolve to let our federal laws function as intended and continued investments in coverage approaches like CHIP and Medicaid that work.

Written by Clayton Travis, Hogg Mental Health Policy Fellow at Texans Care for Children. Cross-posted from Texans Care for Children Newsroom.